PPD and Me

I said there’d be more to come on my returning BFF postpartum depression/anxiety (PPD) and then I went dark on writing. It’s pretty standard behavior for me. About the time I hit “Publish” on a vulnerable post, I start to sweat and sometimes the room spins and I feel ill. This feeling typically continues for a few days. I also go through this routine any time I publicly advocate for anything too so I hope you understand it takes me a while to build up the moxie to do it again!

To be honest, I feel like a bit of an impostor claiming it because on the scale of PPD, it could be a lot worse. I felt (feel?) off. Disconnected. Disengaged. Foggy. “Meh” and a bit emotionless. I started sleeping less. If I suffered through Postpartum Anxiety with Emma, this felt (feels?) like Postpartum Depression. So I read over the pamphlet I got from the hospital and started taking some vitamins. I’m eating better. I called my therapist.

I love being able to say that, by the way: “I called my therapist.” I have a group of girlfriends who all go to a therapist and talking about mental health is as normal as talking about our weekend plans or eating lunch. “What do you mean you didn’t call your therapist?” It’s so good.

The thing about PPD is there’s a dumb little points test called the Edinburgh Postnatal Depression Scale (EPDS) you can take to score yourself but it’s not like you go get a blood test and the results come back positive. You can pretty clearly be diagnosed if you’re having thoughts of harm or bawling uncontrollably all of the time but the rest are subjective questions that you can fudge a bit, whether consciously or unconsciously.

Did you know they’re finding that men suffer similar symptoms of PPD? It’s true. I read it on the Internet. Actually, it was in my hospital pamphlet and I’m over here thinking “Yes! The conversation is continuing to change and grow and I am here for it!” (And if I’m being honest, I’m also feeling a little bit of “Thank God! Women’s health issues are so often minimized; this could bring changes in standard care!”)

What I’m really coming to believe is that everything is relative and when it comes to mental health and self-care, it doesn’t really matter if you have a clinical diagnoses or not. It doesn’t matter if your bad isn’t as bad as someone else’s. Do you feel off? If you feel off, you already know something isn’t right. You don’t have to have permission to work on righting it. You don’t have to go through it on your own because you don’t feel like it’s bad enough. You don’t have to accept some stunted notion that you’re supposed to feel a little off right now. FORGET THAT NOISE. It’s not for me.

There’s a line at the end of the EPDS test that says “If your total is 12 or higher two weeks in a row, or for any continued emotional concerns regardless of the score, call your health care provider.” [Emphasis theirs]

When you’re hovering around but mostly under 12 or increasing every few weeks but you’re not at 12 or if you know you’re off but you’re not scoring, you read the bold text and you think “Oh, so not me?” You’ll completely read over that second part of the sentence which says, “For any continued emotional concerns regardless of the score, call your health care provider.”

Friends, I’m telling you, make the call. Take the vitamins. Tell your people. Join the group. Whatever it is, speed up the process of healing. Don’t buy into this idea that it’s normal to feel (subjectively) a little crappy in the first year. What does that even mean?

Currently Watching: Workin’ Moms

I watched it a few weeks ago but it has STUCK with me. This show is brilliant. First of all, and this is a bit of an aside, I have concluded that Canada and the UK are better than the US at producing content that matters. Workin’ Moms tackling pumping, Postpartum Depression (PPD), going back to work, the imbalance between men and women in the workplace in a way that is hilarious without patronizing. Bodyguard for giving us a look at PTSD in such a lovable character that you aren’t afraid of or pity. Those are only two examples but they’re crushing it.

Second: The main character Kate. She’s a successful business woman who is respected in her field. She has a normal marriage. She makes sacrifices in career and at home in an attempt to find balance but she’s not comedically failing at everything or winning. She’s one of the boys but also tries too hard and gets awkward sometimes. I love her.

Third: Frankie. She’s Kate’s friend. A realtor with PPD. Having read other reviews, I will agree that the depiction of PPD does wander dangerously into Postpartum Psychosis… but I process with humor and I laughed until I cried when her head was in the pool and she got up acting completely normal when potential buyers wandered into the backyard.

One of my girlfriends stopped by the other day around noon with a care package from our group of friends because they recognize that I’m riding the struggle bus. I considered pretending that I wasn’t home (where else would I be?) but I ended up answering the door with a big ol’ smile in my day-wear robe and pajamas like it was some new outfit I was proud of (thank God for friends who see you). In other words, I can relate to the image of jumping up out of the water to wipe the wet hair out of your eyes and flash that “Everything is fine!” smile. Nothing to see here, ya’ll!

Anyway, at one point in the show, Frankie received treatment for PPD. She stops nursing and the lactation consultant in the moms group warns her that weaning causes hormone changes that can lead to PPD. Frankie looks at her and says something like, “No, I already had that. It’s like chicken pox so I can’t get it again.”

Umm, hi.

Remember when I said I didn’t think I had PPD this time around? Well. Thank you, Workin’ Moms for teaching me that weaning causes hormone changes that can change that and also that PPD is not like chicken pox.

Do I get a prize? Because I am acing hormonal imbalance: 2/2!

More on that later…

Postpartum Self Care

The conversations started well before I became pregnant with my son. They came up when people asked me how I felt about pregnancy and about the 4th trimester and about the first year. They came up when one of my friends announced she was pregnant and again when her beautiful baby was born. I was reminded of them when I passed any pregnant woman on the street.

I’ve been having them for years. 4 years, to be exact.

It took me a long time to understand the heart of those conversations. Over time, the shared dialogue about the hard truths of the newborn phase, the darkness felt in that first year, and the loss of self became less about pain and more about understanding and the need for self care.

I was retroactively diagnosed with postpartum depression following my daughter’s birth. I don’t know exactly when my charts were updated, perhaps it was after talking with my OB this time around about the fears I had going into another newborn phase. Perhaps it was after my last pregnancy which ended in miscarriage. I can’t be sure. But I do know that when the nurse in the recovery room read aloud that I had experienced PPD with the last birth and offered to take our sweet baby boy to the nursery for a few hours to love on him so we could get some sleep before going home as a family of 4, I felt seen.

During my daughter’s time as a newborn, the language for postpartum depression focused on sadness and tears. I didn’t have those symptoms. What I had were feelings of anxiety. Obsessive behavior surrounding breast feeding. I felt on the inside the way you feel when you look at a wide-eyed, feral animal in a cage. I felt irreversibly changed. Damaged. Trapped.

I always committed to answer honestly when asked by medical professionals about PPD symptoms but no one seemed to ask just the right question to force me into what felt like a confession. I was unable to offer what I viewed as weakness and therefore consistently flew under the PPD radar.

Fast forward to my second time around:

Postpartum anxiety is now part of the professional conversation. My friends are here with me in this phase of motherhood; they’ve been through it and they’re checking in with me. And I’m open. They’re direct because I’ve told them to be. I’ve tipped them off to my darkest thoughts during my first go as a new mom and I’ve given them signs to watch for in case I don’t recognize those signs in myself. In case I’m unwilling to listen.

The biggest change this time around isn’t in others. It’s in me. I had people who checked in during the first year with Emma and people who pleaded with me to supplement even one night to get some much needed sleep if I refused to ask for help. (Word to the wise: Obsessively setting an alarm every two hours at night in order to alternate pumping and nursing for weeks while your child consistently shows hunger cues and you’re left with mere drops after pumping until you finally wake up one morning with literally nothing to give your child for her next meal is *drum roll, please* INSANITY. Now we both know).

I couldn’t hear anyone the first time around. I couldn’t see it for myself.

I’m a recovering perfectionist, learning to see failure as a step in an ongoing process rather than a condemnation of character. Learning to see it as an opportunity for growth. Learning to see it as a mere fork in the road where one path is now closed for the time being and the other path is just as good albeit different.

Which brings me to back to nursing.

I said I’d try.

I had a traumatic relationship with nursing the first time around but from the outsider perspective, 8 months is respectable enough. You couldn’t see the obsession. The arbitrary measurement of success I had placed upon it. So when I had my first bad latch with baby Freddy and he threw up my very own blood, I felt that anxiety rise but I said I would continue with use of a nursing shield. And the anxiety subsided.

And then my beautiful but sleepy boy began to drop weight so I was scheduled to see a lactation consultant and, to her credit, she did not once shame me for wanting to continue using the shield (a likely cause of weight issues, I came to learn) but instead gave me tips to continue use which involved nursing, then pumping, then immediately feeding what I had pumped. And the newly climbing anxiety began to subside.

Then I actually tried to put into practice what felt so reasonable in her office and it took me 1.5 hours to complete the whole cycle. At which point, I had 30 minutes until I began the cycle again. And so the anxiety began to rise.

When Fred called me on his drive between work engagements to check in, I picked up the phone and immediately began to sob. I felt panicked. Caged. So my husband came home, he took the kids, and he shooed me out of the house to go for a drive. Go to a library, a bookstore, get a coffee. Whatever. And I did. And the anxiety began to subside.

What I’m realizing about self care is that it’s more than simply saying “I will stop before I get to that deep, dark place.”

I didn’t immediately see that I was taking that approach to nursing. “I will try this thing and this other thing to ensure that I can continue nursing even though it is stretching me toward a place I do not want to go. I can still get control of this.”

I don’t believe that I have postpartum depression this time around but I also don’t believe that I need to in order to make self care decisions that may look selfish from the outsider perspective. I am coming to see that self care means allowing yourself more than preventing disaster. It means allowing yourself to thrive.

For me, self care means giving a formula bottle when my supply is fine, knowing that I’m telling my body to produce less. It means nursing only at night, pumping sometimes, and increasing formula. It’s not ideal but it isn’t bad either. It’s giving me room to breathe. It’s taking away some of that anxiety. It’s giving me back control and allowing me to feel whole. And that, my friends, is good.